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Clinical e-News Blog - April

Written by Prof Karen Dwyer, Clinical Director Kidney Health Australia, Nephrologist

The 10th March was World Kidney Day the theme of which was “Kidney health for all. Bridge the knowledge gap to better care”.

Education is a core function here at Kidney Health Australia – education directed towards consumers and for healthcare providers. The majority of individuals with kidney disease are managed in primary care we have been providing accredited education to primary care health professionals for over 20 years. We pride ourselves on being a trusted partner for healthcare providers ensuring contemporary, evidence based and timely delivery of education in a variety of formats including webinars (the most recent webinar held during Kidney Health Week can be found here).

We have created the CKD Management in Primary Care handbook which can be downloaded here, providing comprehensive guidelines for the various stages of CKD. There are a large number of resources available for consumers ranging from learning what kidneys do, to how to live a healthy and productive life with kidney disease. I would encourage you to direct your patients to the website following diagnosis. The Kidney Helpline is a valuable source of information for consumers seeking specific advice.

In this quarterly newsletter, we aim to deliver information on hot topics in kidney health. If you have a specific topic you would like to know more about, please contact me directly at [email protected]
For our first Clinical e-news, I will discuss an approach to haematuria.
Haematuria is defined as the presence of red blood cells in the urine. Haematuria can be classified as gross/macroscopic or microscopic; glomerular or non-glomerular; symptomatic or asymptomatic; transient or persistent; isolated or associated with proteinuria and/or a decline in kidney function and/or hypertension. The term “active urinary sediment” refers to the presence of glomerular haematuria. Following a thorough history and examination a key investigation is to determine if the haematuria is of glomerular or non-glomerular origin. This needs to be specifically requested on the pathology slip (I write – “RBC morphology please”). The presence of non-glomerular haematuria should prompt a urological assessment; the presence of glomerular haematuria and acute kidney injury requires prompt nephrological assessment. Most commonly low-grade isolated haematuria (for example, 50 x 106 red blood cells) does not require specific treatment, but rather surveillance for the appearance of other signs or symptoms indicative of progressive kidney disease (6-12 monthly BP check, UECr, uACR). If these emerge, then referral to a nephrologist may be warranted.

“Education is the most powerful weapon which you can use to change the world.” – Nelson Mandela